NURS 1566 Clinical Form 3: Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency

Ipratroprium BR Atrovent Anticholinergics, 0.02% solution INH QID
brohchodilators
Peak Onset Duration Normal dosage range
1-2 hr 5-15 min 3-4 hr (up to 8 1-4 inhalations 3-4 times a day
hr)

Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
Exacerbation COPD N/A

Mechanism of action and indications Nursing Implications (what to focus on)

(Why med ordered)
Mechanism of action: Inhibits cholinergic receptors in bronchial
smooth muscle, resulting in decreased concentrations of cyclic
guanosine monophosphate (cGMP). Decreased levels of cGMP
produce local bronchodilation.
Indications: Maintenance therapy of reversible airway obstruction
due to COPD
Interactions with other patient drugs, OTC or herbal
medicines (ask patient specifically)
None
Nursing Process- Assessment
(Pre-administration assessment)
Assess for allergy to atropine and belladonna
alkaloids; patients with these allergies may also be
sensitive to ipratropium. Assess for peanut or soy
allergy. Assess respiratory status (rate, breath sounds,
degree of dyspnea, pulse) before administration .
Contraindications/warnings/interactions
Hypersensitivity to ipratropium, atropine, belladonna alkaloids, bromide;
Avoid use during acute bronchospasm;
Common side effects
CNS: dizziness, headache, nervousness, EENT: blurred vision, sore
throat, nasal only: epistaxis, nasal dryness/irritation, Resp:
bronchospasm, cough, CV: hypotension, palpitations, GI: GI irritation,
nausea, Derm: rash, Misc: allergic reactions
Lab value alterations caused by medicine
None found
Be sure to teach the patient the following about this
medication
Instruct patient in proper use of nebulizer and to take medication as
directed. Advise patient that rinsing mouth after using inhaler, good oral
hygiene, and sugarless gum or candy may minimize dry mouth. Health
care professional should be notified if stomatitis occurs or if dry mouth
persists for more than 2 wk. Explain need for pulmonary function tests
prior to and periodically during therapy to determine effectiveness of
medication. Caution patient to avoid spraying medication in eyes; may
cause blurring of vision or irritation. Advise patient to inform health care
professional if cough, nervousness, headache, dizziness, nausea, or GI
distress occurs.
Assessment Evaluation
Why would you hold or not give this Check after giving
med? respiratory status (rate, breath
if severe bronchospasm is present; onset of sounds, degree of dyspnea, pulse)
action is too slow for patients in acute distress.
If wheezing occurs, withhold medication and
notify physician or other health care
professional immediately.